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Wed Jun 16 13:28:06 BST 2010

can u tell the technique of femoral nerve block

--- On Tue, 6/15/10, Ian Seppelt <seppelt at med.usyd.edu.au> wrote:

From: Ian Seppelt <seppelt at med.usyd.edu.au>
Subject: Re: Knee Dislocations
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Cc: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Date: Tuesday, June 15, 2010, 11:23 PM

I've used a femoral (probably really 3 in 1) nerve block to reduce a dislocated knee prehospital, in a patient I really did not want to anaesthetise before he was winched out. A bit of morphine helped too!

Ian Seppelt, Sydney.

On 16/06/2010, at 9:09 AM, gmelnick at efn.org wrote:

> In the same vein:
> 
> What is the list's opinion about _prehospital_ reduction of dislocations?
> 
> I'm thinking in the context of wilderness/disaster injuries with extended
> evacuation times (multiple days) to any kind of facility. I work on a
> special prehospital team that provides ALS/paramedic care in the
> backcountry (in addition to normal 911 response), and we have a limited
> protocol for shoulder/hip reduction under certain circumstances. The
> protocol does allow for conscious sedation to aid in joint reduction. To
> my knowledge the protocol has only been used a few times.
> 
> What dislocations are appropriate to consider reducing without any kind of
> radiology? Is neuro/vascular compromise the only real indication in this
> setting? Is the availability of IV analgesia/sedation essential, or merely
> desirable (thinking about the disaster context)?
> 
> Thanks,
> 
> Garth Melnick, EMT-P
> Reach & Treat Team
> Portland, OR, USA
> 
>>>>> "Bjorn, Pret" <pbjorn at emh.org> 16/06/2010 2:13 am >>>
>>>>> 
>> Recommendations for rural management?  Is it safe for the local EM
>> provider to reduce on site; or are operative/angiographic backup a
>> prerequisite?
>> 
>> References appreciated.  I'm coming up short with PubMed and Google
>> Scholar.
>> 
>> 
>> Pret Bjorn, RN
>> Bangor, ME USA
>> 
>> 
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> 
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